泪点并置综合征诊治的研究现状

Diagnosis and treatment of punctal apposition syndrome

泪点并置综合征指同一只眼的上下泪点在瞬目的整个过程中均保持贴合(并置),导致泪液引流障碍的一组综合征。主要临床表现为溢泪,以及内侧上睑下垂伴脂肪脱垂、下睑松弛、泪点并置三联征。本综合征多见于老年人,至今尚未被国内的眼科医师广泛重识。上下泪点并置而导致机械性阻塞、眼睑及外眦韧带松弛导致泪泵功能障碍,二者的作用导致功能性溢泪。近年来,泪点并置综合征的诊治引起了国内外学者的关注,并取得了较大的进展。本文扼要综述了泪点并置综合征的病因和致病机制、临床表现、诊断和鉴别诊断、治疗和预后以及前景展望。

Punctal apposition syndrome(PAS)refers to a group of syndromes in which the upper and lower puncta stay together(apposition)throughout the entire process of blinking of the same eye,which leads to lacrimal drainage disorder.The main clinical manifestations are epiphora,medial ptosis with fat prolapse,lower eyelid laxity and punctal apposition.It is mostly seen in elderly people,and it has not been widely recognized by domestic ophthalmologists so far.The mechanical obstruction caused by punctal apposition and the dysfunction of the lacrimal pump due to the relaxation of the eyelid and lateral canthus ligament are factors both leading to epiphora.In recent years,attention has been paid to the diagnosis and treatment of punctal apposition syndrome both domestically and internationally,and significant progress has been made.This paper provides a brief review of the etiology and pathogenesis,clinical manifestations,diagnosis and differential diagnosis,treatment and prognosis,as well as the existing problems which need to be solved for punctal apposition syndrome.